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By Amberle Phillips, MA, ATC, SCAT
Athletic Trainer
MUSC Health Sports Medicine

Adequate amounts of sleep are vital for athletic performance and mental function. This is especially true for younger athletes. Sleep deprivation among college-aged athletes can be attributed to travel for sport, stress, balancing academics, athletics, and social life. The National Athletic Trainers’ Association recommends eight hours of sleep for individuals aged 17-22 years.

Sleep deprivation may impact mental health. The body’s ability to deal with stress and emotions depends on sleep to regulate proper functionality. Without sleep the mind is unable to process situations effectively and may cause emotional instability and inability to process stressful situations. Mood and depression are also affected by lack of sleep. Sleep deprivation may cause increased depression and other mood swings. The mind is not the only thing that is impacted by lack of sleep; the body’s cells are also affected.

During sleep is when the cells in the body grow, repair and rebuild helping injuries heal and preventing further injury from occurring. Cells need the rest that sleep provides to catch up on the days’ work that the body did. The cells will repair themselves and create new cells to assist in growth, and repair. The healing of cells that takes place during sleep is also the time when muscle cells and tissue can grow. Poor sleep and shortened sleep may also lead to weight gain and obesity. This is especially true in adolescents whom require more sleep than adults.

Here are a few tips and tricks that can be done to help fall asleep and to stay asleep:

  • Turn off all devices 1 hour prior to bedtime
  • Create a bedtime routine
  • Exercise daily
  • Meditation or total muscle relaxation techniques
  • Avoid caffeine late in the day
  • Stick to a schedule, even on the weekends

By Stephanie Davey, MEd, ATC, PES
Athletic Trainer
MUSC Health Sports Medicine
www.MUSCHealth.org/Sports

The middle of July means that high school football is just a couple of weeks away. In South Carolina, most of our high schools start around July 27th. If your son is planning to play football and go through preseason, there are a few things they need to focus on off the field in order to be safe and productive on the field.

Hopefully, your son has already been working on his conditioning. This will go a long way to him being able to acclimate to the South Carolina heat. South Carolina High School League mandates an acclimatization practice plans that all high schools must follow. If you have questions about that plan you can find it on the South Carolina High School League website

Hydration is always the first thing that comes to mind when we think of preseason football. Your son must be hydrated prior to reporting to practice each day. There is no way to catch up if they are already dehydrated when they arrive. Two ways to tell if they are hydrated is monitoring the color and volume of their urine and making sure they weigh in and out of practices. Their urine should be a light yellow color and high in volume before they go to bed each night. Secondly, they should be weighing in prior to practice and out after practice. They can do this at home or with their athletic trainer. For every pound that they lost during practice, they need to drink 20-24 oz of fluid. If they do not regain the weight they’ve lost during the previous practice, they may need to be held out of practice until they’ve rehydrated. To rehydrate, they should consume water and a sports drink. Soda and beverages with a high caffeine content should be avoided. Energy drinks should not be consumed at all.

The next thing to focus on is proper nutrition. The body is just like a car, the better fuel you put in it the better it performs. Your son needs quality food that is high in nutrition volume with a good balance of carbohydrates, proteins, and fats. Your son needs 40 – 50 kcals/kg of body weight. They should consume 4-8g/kg of carbohydrates and 2-3 g/kg of proteins.  Foods to focus on are lean meats, eggs, nut butters, protein shakes, pastas, and fruits and vegetables. Fruit and vegetables with a high water content can also help to hydrate. Your son needs to eat prior to practice, even if it is an early morning practice. It shouldn’t be a big heavy meal, but they need to have some source of energy before practice.

The last thing to focus on is sleep. The National Institute of Health recommends that high school athletes get an average of 9-10 hours of sleep each night.  Proper sleeping habits with allow your son’s body the time it needs to recover after each practice.  It allows him to stay focused and think clearly during practice. Better recovery and better focus leads to better performance.

Taking these steps will go a long way towards protecting your son during preseason football, ensuring that he has a fun, productive and safe football season.

By Alecia Good, MEd, ATC
Athletic Trainer
MUSC Health Sports Medicine

A young athlete collapses to the ground in front of you. No trained emergency personnel are present on the scene. Would you know what to do?

As the athletic trainer at Pinewood Preparatory School, I have posted Emergency Action Plans in every sports venue. The plans include what to do, who to call, and exact locations for dispatch if there is a need to call for emergency personnel. The hope is that if an emergency should ever occur and I am not there the first responders (usually coaches), will know how to respond. Two weeks ago, these plans were put into place and the first responders were able to save a young man’s life.

One evening a few weeks ago, several alumni gathered to play pick up basketball in our gym. Around 8 pm one of the players crashed to the ground and was unresponsive with sudden cardiac arrest. The other players quickly acted to find two coaches that were in the other gym, send someone for an automated external defibrillator (AED), and call 911. Within minutes, one coach performed hands-only CPR while the other quickly attached and turned on the AED. They continued their rescue efforts until the paramedics arrived. 

Once at the ER it was reported that emergency personnel were able to regain a pulse after at least 10 to 20 minutes of the young man’s heart being stopped. The question the doctors then began to ask was what the brain function would be like because his heart was stopped for such a long duration. The doctors were comforted by the fact that early CPR and defibrillation was performed. 

After only 2 minutes without oxygen-rich blood from the heart, brain cells can start to die. After 6 minutes, brain death occurs. According to the American Heart Association, “Sudden Cardiac Arrest is a leading cause of death in the U.S.—but when ordinary people, not just doctors and EMTs, are equipped with the skills to perform CPR, the survival rate can double, or even triple.”

The young man was placed in a medically-induced coma with a cooling therapy for a few days. After his body was brought back up to temperature and the paralytic drugs were discontinued, the young man woke and returned to normal function. He was talking and moving around and has since been discharged from the hospital. 

Early CPR to manually pump the blood to the brain and early defibrillation to shock the heart back into rhythm is without a doubt what saved this young man’s life. Had the coaches and students not acted quickly to enact the emergency action plan, this story would not have had the same happy ending. To reiterate my colleague’s blog on the importance of knowing CPR, please take the time to learn CPR and how to use an AED. Here is a link for hands-only CPR from the American Heart Association. Even if you don’t have time to take a full course, this compression only technique can save a life as it did in this situation. More importantly, know your surroundings and be willing to act in the event of an emergency. Take note of where there may be emergency equipment (AED, first aid kit) and know your location to be able to give accurate directions. Any delay in action can be the difference in the outcome of the emergency.

By Michael J. Barr, PT, DPT, MSR
Sports Medicine Manager
MUSC Health Sports Medicine

MUSC Health Stadium

Major League Lacrosse is coming to Charleston and MUSC Health Stadium! MLL announced in April that the Charleston Battery will host the 2018 MLL Championship at MUSC Health Stadium on August 18. Luckily, we do not have to wait until August to see Major League Lacrosse in action, as the first-ever MLL game in the state of South Carolina is right around the corner on June 30 at MUSC Health Stadium. This inaugural game is a match between the Charlotte Hounds and the Atlanta Blaze.

The buzz around the Charleston lacrosse community is the excitement about the upcoming matches. Over the past 10 years, lacrosse has been one of the fastest-growing sports in the Lowcountry and throughout the United States. According to USA lacrosse’s 2016 survey, there are over 825,000 players participating in organized lacrosse throughout the country, which is an increase of over 225 percent compared to their first survey completed in 2001.

As the game grows in popularity and participation, the topic of injuries always comes up. Parents are concerned for their children’s well being, as they are with participation in all sports. A study completed by Xiang et al., and published in the American Journal of Sports Medicine in 2014, examined the number of high school lacrosse injuries (male and female) from 2008 to 2012. The top injury type was sprains/strains (38.3 percent) followed by concussions (22.2 percent) and abrasions/contusions (12.2 percent). The majority of the injuries were to the lower extremities (foot/ankle, knee, and thigh). In approximately 40 percent of the injuries that occurred, the players were able to return to play within 1 to 6 days and only 6.6 percent of the total injuries were serious enough to require surgical intervention.

So just like in all sports, injuries can occur in lacrosse, but there are also ways to minimize this risk through injury prevention techniques. Stop Sports Injuries has a full list of injury prevention guidelines for lacrosse players.

To prevent most prevalent injuries, sprains/strains, and concussions, here are my suggestions:

Sprains/Strains:

  1. Proper warm-up prior to play: This should include active movement in addition to both dynamic and static stretching.
  2. In season strengthening program: Focus on balance, dynamic stability, and core strengthening.
  3. Offseason training: Fitness training in the offseason can be the most important step to injury prevention. This should include a combination of cardiovascular training, strengthening and flexibility programs, plyometric training, and agility training.

Concussions:

  1. Know the rules and follow the rules: In boys’ lacrosse, when played correctly, unprotected hits should not occur, and in girls’ lacrosse there should be no head/face contact. Unfortunately, rules are not always followed or taught to players, so this is where experienced coaching comes into play.
  2. Wear the proper equipment: Lacrosse equipment is designed to be protective, but if helmets, facial equipment, and mouth guards are worn out or the wrong size, they may not be doing their job, which can lead to increased injuries.
  3. Know the signs and symptoms: If a hit occurs and there is a suspicion of a concussion, players should be held out of play until assessed by a health care professional trained in concussion management. Athletic trainers are your best resource for on-field management. If a concussion does occur, follow return-to-play guidelines to minimize the risk for escalated symptoms or future issues.

In lacrosse, just like in all other sports, there is a risk for injury, but the overall benefits of sports participation significantly outweigh the risks.

If you have read this far, you must be interested in the game, see how the elite do it, and come out to the game on June 30 and all of the festivities surrounding the Major League Lacrosse Championship at MUSC Health Stadium in August.

By Brittney Lang MS, ATC
Athletic Trainer
MUSC Health Sports Medicine
www.MUSCHealth.org/sports

Summer workouts for athletes have started and with temperatures and humidity rising daily as we get closer to summer we have to be aware of making sure our athletes are properly hydrated. Athletes should have access to water during any weights and conditioning sessions and given breaks during sessions as needed. It is also necessary to educate athletes on the importance of hydrating well before and after physical activity to maintain good health.

An athlete needs to be properly hydrated if they want to be able to perform at their highest level. Physical activity, heat, and humidity increase the amount of fluid your body needs to stay hydrated.  Below are recommendations for how much fluid one should be drinking to maintain adequate levels.

Everyday
Drink adequate fluids. Roughly 1 ml for every calorie consumed. For example, if you eat 4000 calories, drink 4000 ml of fluids (4 L).

2 to 3 hours before training/competition
7 oz of fluid

Immediately prior to training/competition
6 to 12 oz of fluid

Every 15 to 20 minutes during training/competition
6 to 12 oz of fluid

Exercise longer than one hour
Be sure to include a carbohydrate source in the form of solid, gel or sports drinks. Consume roughly 30 to 60 grams of carbohydrate per hour. 600 to 1200 ml of a sports drink will fulfill this need.

After exercise 
16 to 24 oz for every pound lost from the training session or competition.

It is good practice to do a pre and post workout weight check to make sure the athlete has been consuming enough during the workout; and to see if they have lost any weight and determine how much extra they may have to replenish.

Staying well hydrated will help decrease the risk of heat illnesses such as muscle cramps, heat exhaustion and heat stroke by helping with body temperature regulation and cooling efficiently.

Dehydration

The body loses fluid through the skin as sweat, through the lungs while breathing, and through urination. When the body loses more fluids than is being taken in to replace what is lost we have dehydration. There are some common signs and symptoms of dehydration to look out for during training:

  • Headache
  • Nausea
  • Dizziness
  • Thirst
  • Fatigue
  • Muscle cramping
  • Low output of urine/dark coloration

If an athlete is experiencing any of these symptoms, they should stop what they are doing and drink fluids. An athlete should not completely rely on their thirst mechanism to tell them to drink. If the athlete feels thirsty, it is too late. The body has begun to feel the effects from dehydration and their performance will suffer along with their body. One should not wait that long.

Over hydration

While dehydration is more common in athletes, there is a very real possibility of over hydration. This is when the athlete intakes more water than the body has released i.e through sweat. This can lead to low sodium levels also known as hyponatremia and cause very severe health problems if the athlete does not seek the necessary help right away. Drinking some sport drinks during longer or intense workout sessions can help with keeping sodium levels up and eliminate the possibility of hyponatremia during training.

Hydration is one of the most important things an athlete can do to maintain mental and physical performance. Educating the athlete on proper hydration techniques is the best way for them to stay healthy.

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